CMS Changes Medicare Prescription Coverage for Insulin and Vaccines

10-19-2022

On Jan. 1, 2023, cost sharing for insulin products will be capped at $35, which may be less than plans’ stated cost share.
 
Also, effective Jan. 1, 2023, adult vaccines recommended by the Centers for Medicare & Medicaid Services will be covered at $0 cost share.
 
Why it matters:
The insulin cost share cap and $0 cost share adult vaccines will be provided regardless of formulary tier or benefit phase. Get the details.